Glaucoma
is the leading cause of blindness in the United States. It is a disease
that typically affects older people, but it can occur at any age.
Loss of vision is preventable if the disease is detected early and
treatment is started.

The eye has about 1 million tiny nerve fibers which run from the back
of the eye to the brain. These nerve fibers allow us to see. Glaucoma
is a disease which causes the destruction of these fibers. It was
once thought that the loss of these fibers was due to strictly to
high pressure in the eye. But now it is known that even patients with
normal eye pressure can have glaucoma and loss of these nerve fibers.

In many patients, the disease is not noticed in the early stages,
because there is no pain and no noticeable change in vision. Early
detection by an eye doctor is the key to the prevention of vision
damage from glaucoma. Routine eye examinations are recommended.

Types of Glaucoma

The reason that eye pressure is high in many glaucoma patients is
that the drainage system in the eye is not working properly. The fluid
in the eye, called aqueous humor, does not flow out of the eye as
quickly as it should. The drainage system lies in a part of the eye
called the angle, which is between the outer layer and the iris of
the eye. This angle can be open or closed.

There are several kinds of glaucoma. The most common form of glaucoma
is called chronic open angle glaucoma. The drainage angle is open
in these patients, but the eye fluid does not drain as quickly as
it should. Closed-angle glaucoma occurs when the drainage angle closes,
and almost no eye fluid can escape. During closed-angle glaucoma,
eye pressure can get very high and there is pain. Angle closure glaucoma
is an emergency and must be treated immediately. If the high pressure
is allowed to continue for too long, blindness can result.

Some persons are more likely to have glaucoma. These include persons
who are older, have nearsightedness, have a family history of glaucoma,
have had past eye injury, have diabetes or have a past history of
vascular shock. Also, African-Americans are 6 times more likely to
have the disease.

Glaucoma is treated with eye drops that lower the eye pressure. If
the pressure does not fall to a low enough level with drops, then
surgery may be necessary. Glaucoma surgery opens up the drainage system
in the angle so that the eye fluid can flow more freely.